Support insert associated with spinal vertebrae

ABSTRACT

An insert for establishing a desired spacing between a pair of succeeding vertebrae and having a body including an extending end for supporting a location associated with a first selected lumbar vertebrae. An opposite extending end supports a spaced apart and opposing location associated with a second successively positioned lumbar vertebrae. Upon pre-positioning the body in an open space established between the vertebrae, an actuating input causes the first extending end to displace outwardly relative to the second end and into contacting support with the vertebrae.

CROSS REFERENCE TO RELATED APPLICATIONS

The present invention claims the priority of provisional applicationSer. No. 61/107,851, filed Oct. 23, 2008.

FIELD OF THE INVENTION

The present invention teaches a number of improved spinal vertebraesupport implants. In particular, the present inventions disclose andinclude an ergonomically fitting and elevating jack insert, such as forinsertion between succeeding lower lumbar vertebrae. In combination withselective cushioning implants and/or additional supporting/reinforcingstructures established between the vertebra, the elevating jack insertsoperate to establish a desired vertical spacing (as well as alsooptionally providing a further degree of lateral/torsional support)between selected lumbar vertebra. The provision of theinsertable/elevatable jack insert also serves to prevent pain to theuser (such as resulting from the pinching or contacting of nerves in thespinal column and due to spinal column misalignment, scoliosis and thelike. Additional variants include the provision of both fixed andlinearly extensible brace supports for installation about succeedingvertebral processes

DESCRIPTION OF THE PRIOR ART

The prior art is well documented with various examples of spinal columnimmobilizing and bracing assemblies. A typical example of a spinal braceincludes a titanium or like metal plate screwed or otherwise affixed toany plurality of spinal vertebrae and for the purpose of fixing andimmobilizing the vertebrae in a specified arrangement and in order tocompensate for damage existing in particular along an interface betweensucceeding vertebrae. The downsides of such existing immobilizingtechniques include the discomfort and pain associated with theimplanting of the brace, as well as significantly limiting theindividual's flexibility of motion.

SUMMARY OF THE PRESENT INVENTION

The present invention discloses a jack insert for establishing a desiredspacing between a pair of succeeding lumbar vertebrae having a bodyincluding a first extending end for supporting a first locationassociated with a first selected lumbar vertebrae and a second andopposite extending end for supporting a second spaced apart and opposinglocation associated with a second successively positioned lumbarvertebrae. Upon pre-positioning the body in an open space establishedbetween the vertebrae, an actuating input triggers an internal mechanismwhich causes the first extending end to displace outwardly relative tothe second end and into contacting support with the vertebrae.

Additional features include the body being constructed of a plasticexhibiting at least one different durometer rating, and with the firstand second ends further including cup shaped portions separated by anintermediate stem. In another application, the upper and lower halvescan each further exhibit an outermost and softest durometer portion andan inner and hardened durometer portion. A key insert location withinthe stem actuator a length displacement rod to outwardly displace thecup shaped ends.

Other features include the plastic body exhibiting at least onedifferent durometer rating and including an upper half and a lower halfnestingly engaged in a closed position. The actuating input can furtherinclude a displacement mechanism established between the upper and lowerhalves and, upon actuating, causing the upper half to outwardlydisplace. The upper and lower half of the body can each further includea recessed seating configuration for engaging the opposing vertebrallocations, with such recessed configurations each including at least oneof serrations, ridges and grooves.

Other features include the displacement mechanism exhibiting astationary rotatable drive screw contained within the lower half, a liftscrew arranged in crosswise and upwardly displaceable fashion relativeto the drive screw and for upwardly displacing the upper half. One ormore inflatable and cushioning inserts can each include a hardened ringexterior and a biasing fluidic interior, such that the insert issupported at a location between the vertebrae additional to a mountinglocation associated with the jack insert body.

Additional contemplated features include the provision of clips forsecuring between the vertebrae and to prevent misalignment of thecushioning insert. Also, a mounting screw can extend from the lower bodyhalf to engage a lower selected vertebrae.

In another variant, a central supporting jack insert can also bepositioned at a central location between the vertebrae, with a pair ofauxiliary jack inserts engaging extending process locations of thevertebrae. Such a jack displacement mechanism can include, withoutlimitation, any of a screw lift worm gear, a screw lift bevel gear, ascrew lift ratchet, a rotating screw lift, a rack gear pinion lift, anda rack gear ratchet lift. The jack displacement mechanism may alsoinclude, without limitation, any of a step slot spring lift, a step ringspring lift, a screw scissor lift, a cam lift ratchet lock, a push inwedge block lift, screw wedge block lift, displaceable wedge or keyhole, pump lift air compressor, pump lift filler plastic, pump lifthydraulic, and a balloon ring filter plastic lift.

Additional variants include the provision of spinal brace supports,these providing both upper/lower and side assembleable variants andwhich upon installation, operate to positionally support successiveextending processes associated with adjoining vertebrae. The spinalbraces can also be used cooperatively or independently with the variousspinal jacks and either can be provided in a fixed or expandableconstruction.

BRIEF DESCRIPTION OF THE DRAWINGS

Reference will now be made to the attaches drawings, when read incombination with the following detailed description, wherein likereference numerals refer to like parts throughout the several views, andin which:

FIG. 1 is a front plan view of a first installation arrangement of aspinal insert jack, in addition to the provision of secondary auxiliaryjack supports supported between transverse process portions ofsucceeding lumbar vertebrae;

FIG. 2 is an illustration of a spinal jack insert according to apreferred embodiment of the present inventions;

FIG. 3 is an illustration of a human spinal column according to theprior art and identifying the various types of spinal vertebraeincluding the atlas cervical 1, axis cervical 2, main cervical 3,thoracic 7, lower lumbar 5, sacrum 6 and coccygeal 4;

FIG. 4 is a side view of a pair of succeeding lower lumbar vertebrae andillustrating one potential arrangement including a variation of anelevating jack insert establishing a generally elongated shape and whichis installed between spaced apart superior articular processes, as wellas a forward located and fluid filled cushioning insert disposed betweena main body associated with each of the vertebrae;

FIG. 4A is a rotated top plan view illustration of the cushioning insertshown in FIG. 4;

FIG. 4B is an enlarged side plan view of the cushioning insert;

FIG. 5 is a rear view of the arrangement shown in FIG. 4;

FIG. 6 is an illustration of the elevating jack insert and furtherillustrating the provision of a key insert for adjusting an overalllength of the jack and thereby establishing a lateral height adjustmentassociated with the oppositely extending cup shaped ends of the jack;

FIG. 7 is a first side view of a further engagement relationship of aset of ballasting inserts established between a pair of succeeding lowerlumbar vertebrae, as well as forward and side installed retaining clips;

FIG. 8 is a rotated side view of a pair of lower lumbar vertebrae andfurther showing a two piece elevating jack insert secured betweenrespective superior articular processes according to a further preferredembodiment;

FIG. 9 is an illustration of a two piece spinal vertebrae jack insertexhibiting first and second extending and undercut support arms, as wellas surface located undercut (contact) teeth for positionally locatingand restraining the jack when pre-installed at the desired locationbetween the lower lumbar vertebrae;

FIG. 10 is a corresponding illustration of a two piece elevating spinalinsert jack according to a further possible variant and which againillustrates a pair of undercut arms extending from a first upper piece,as well as a pair of mounting pins extending from a secondinterconnected lower piece, and for securing the jack in place;

FIG. 11 is an assembled illustration of a two piece spinal jackaccording to a preferred embodiment of the present invention;

FIG. 12 is an illustration of a tool engaging a jack initiating locationassociated with the two piece spinal jack;

FIG. 13 is rotated and underside perspective of the spinal jack of FIG.11 and illustrating both the underside recess configuration of theselected jack portion, as well as the provision of a plastic or metalscrew for mounting the jack to a lower vertebral location;

FIG. 14 is an illustration of a lower portion of the spinal jack (thetop elevating portion being removed) and showing the feature of thebeveling arrangement for translating a tool employed and rotationalinput of a first component to a vertical displacement of a secondcomponent against the upper jack portion;

FIG. 15 is a front plan line art cutaway of a screw lift worm gearconfiguration incorporated into a two piece spinal vertebrae supportedand elevating jack;

FIG. 16 is an illustration of a nature similar to that in FIG. 15 andfurther depicting a screw lift bevel gear incorporated into a spinaljack;

FIG. 17 is an illustration of a screw lift ratchet incorporated into aspinal jack;

FIG. 18 is an illustration of a screw lift put in place jack;

FIG. 19 is an illustration of a rack gear pinion lift jack;

FIG. 20 is an illustration of a rack gear ratchet lift jack;

FIG. 21 is an illustration of a step slot spring lift jack;

FIG. 22 is an illustration of a step ring spring lift jack;

FIG. 23 is an illustration of a screw scissor lift jack;

FIG. 24 is an illustration of a cam lift ratchet lock jack;

FIG. 25 is an illustration of a push in wedge block lift jack;

FIG. 26 is an illustration of a screw wedge block lift jack;

FIG. 27 is an illustration of a pump lift air compress lift jack;

FIG. 28 is an illustration of a pump lift filler plastic lift jack;

FIG. 29 is an illustration of a pump lift hydraulic jack;

FIG. 30 is an illustration of a balloon ring filler plastic lift jack;

FIG. 31 is an illustration of a balloon shaped filter plastic lift jack;

FIG. 32 is an illustration of a spinal jack according to a yet furthervariant and which discloses a pair of inwardly facing and opposing wedgeblocks separating upper and lower jack halves, a flexible membraneencircling a perimeter of the jack halves, in supporting fashion overthe wedge blocks, and flexing in response to outward displacementbetween the jack halves;

FIG. 33 is an illustration of a related variant to that shown in FIG. 32and by which a single laterally displaceable wedge block is employed andengages an end stop defined at a side wall location of the lower spinaljack half;

FIGS. 34 and 35 a-b are respective end and frontal plan viewillustrations of an eccentric/oval shaped element, such including anexterior profile exhibiting an encircling concave pocket for seatinglyengaging opposing vertebral locations, as well as a biasinglydeflectable open interior for providing a measure of cushioning andresilient support, such as upon rotating the pre-located body (FIG. 35a) to an upwardly disposed and maximum elevation (FIG. 35 b), the ovalshaped element further comprising a pair of pins for securing to thevertebrae in its final location and to prevent slippage;

FIG. 36 is an illustration of an inboard lift ball configuration and bywhich first and second lift components are relocated to interior andopposing locations between a pair of lumbar vertebrae and approximate anextending location of the spinal cord and nerves;

FIG. 37 is a succeeding illustration to that shown in FIG. 36, and bywhich the lumbar vertebrae are separated by virtue of a pliers toolutilized for manipulating an insert ball contained between theinter-engaged lift components and rotating a lock ring to maintain thespaced relationship established therebetween;

FIG. 38 is an illustration of a succeeding embodiment and by which analternatively configured pair of lift components are arranged atlocations similar to those shown in FIG. 36, a pair of lift pliers againbeing employed to reposition an upper vertebra supporting componentincluding an outer sleeve which seats over an inner stem associated witha lower vertebra supporting component, opposing edges of the outersleeve and inner stem further exhibiting such as serrated/ratchet teethto maintain a selected height;

FIG. 39 is a further illustration of an inboard screw lift variant,exhibiting lift components similar to those shown in FIG. 38, and inwhich the opposing outer sleeve and inner stem further exhibit opposingand screw adjustable threads placed thereon;

FIG. 40 is an illustration of a “U” shaped spacer component in crosssection and which is secured at an inner converging location of a pairof lumbar vertebrae; and

FIG. 41 is an illustration of an inboard screw ring lift, this featuringthe general configuration of the sleeve and stem shaped components ofFIG. 39, and by which an outer rotatable ring component is employed forestablishing a selected lifting displacement between the upper and lowervertebrae supporting components;

FIG. 42 is an illustration of a further modified lift jack incorporatedat an interface location between succeeding spinal vertebrae andillustrating the feature of arcuate extending anchoring screws withserrated end fixing portions in combination with outer guide sleevesincorporated into the lower half of the jack;

FIG. 43 is a sectional view of the anchoring screw and sleeve removedfrom the jack body in a first arcuate bent configuration;

FIG. 44 is a successive view of the screw and sleeve in a further morestraightened configuration;

FIG. 45 is an illustration of a further elevating jack which exhibitsopposite and outer textured surfaces for assisting in locating midgripping opposing vertebral locations;

FIG. 46 is a yet further example of a fixed and increased height jackexhibiting the textured surfaces also shown in the variant of FIG. 45;

FIG. 47 is an illustration of a pad surfacing associated with upper andlower contact locations of the spinal jack and exhibiting a desiredundercut pattern for promoting generation and adherence of bone marrow;

FIG. 48 is a plan view of an elevating jack incorporating the marrowgrowth promoting patterns on each of upper and lower facing surfacesassociated with the upper and lower jack halves;

FIGS. 49-57 are plan view illustrations of further modified undercutpatterns for promoting the adhesion of marrow between spinal jacksurfaces and their respective upper and lower vertebral contactlocations;

FIG. 58 is an illustration of a yet further variant of spinal jackhaving a one piece construction and illustrating upper and lowergenerally clamshell halves interconnected along a living hinge, a keyaperture defined in an end location communicating with an interfacebetween the clamshell halves such that, upon insertion of a key portion,causing the halves to outwardly deflect;

FIG. 59 is a succeeding illustration to that shown in FIG. 58 andshowing the key portion inserted within the outwardly expanded clamshellhalves;

FIG. 60 is a lengthwise cutaway of the expanded jack shown in FIG. 59;

FIG. 61 is a perspective illustration of a spinal jack according to ayet further preferred embodiment;

FIG. 62 illustrates a linear cutaway of the spinal jack of FIG. 62 andshowing a groove and slot arrangement defined between upper and lowerhalves in combination with a ball seating within a first largerconfigured pocket established between opposing interior surfaces of thehalves;

FIG. 63 is a succeeding illustration to that shown in FIG. 62 andillustrating the ball being laterally displaced along the interiorboundary established between the opposing halves to a further smallerconfigured pocket corresponding to a linearly expanded position,combined with a folded over and living hinge associated with at leastone of the groove and slot configurations;

FIG. 64 is an illustration of a cam lift configuration of spinal jackaccording to a yet further embodiment in a first collapsed position;

FIG. 65 is a succeeding illustration to that shown in FIG. 64 andshowing upper and lower portions in a successive expanded position, suchas incorporating a groove and slot arrangement and inert displaceableball as shown in FIG. 62;

FIG. 66 is an illustration of a rotational lift variant of spinal jackincorporating outer disk portions between which is sandwiched arotatable portion, coacting surfaces established between the outer disksand inner rotating portion causing outward displacement of the disks;

FIG. 67 is an illustration of a combined tool and rotational lift jack,the tool illustrating inwardly opposing bit engaging portions whichengage surface exposed keys associated with the inner rotatable portionand seating within central apertures associated with the outer disks;

FIG. 68 is an illustration of a clamshell constructed spinal jack withliving hinges, similar to previously shown in the embodiment of FIG. 58,and illustrating a modified key aperture for providing access to aninteriorly seated ball;

FIG. 69 is a lineal cutaway of the clamshell design as shown in thepre-expanded position of FIG. 68 and incorporating communicating innerboundary seating pockets as shown in the further variant of FIG. 62 andwith the ball seated within a first enlarged pocket;

FIG. 70 is a succeeding lineal cutaway of the clamshell halves inoutwardly deflecting fashion in response to the ball being displaced,such as by a tool inserted through the key aperture, to a second smallerconfigured pocket;

FIG. 71 is an illustration of a cam lift variant of jack;

FIG. 72 is a lineal cutaway of FIG. 71 and showing an inner rotatablecam element positioned between arcuate inner facing boundariesestablished between the first and second halves of the jack in additionto interfacing grooves and slots defined between the cam halves forfacilitating outward displacement;

FIG. 73 is a successive lineal cutaway illustrating the cam lift jack ina rotated and outwardly displaced position;

FIG. 74 is an illustration of a further variant of spinal jack insertand which illustrates a displaceable wedge lift supported within a trackassociated with the lower jack half and exhibiting an upper steppedprofile which is engageable with a mating and downwardly stepped profileassociated with the upper jack half;

FIG. 75 is a cutaway illustration of the jack shown in FIG. 74 in afirst inserted and design position;

FIG. 76 is a successive illustration of the jack in which the wedge isdisplaced, via such as a tool inserted into an interior key access hole,and in order to upwardly step the upper half relative to the lower half;

FIG. 77 is an illustration of a rear insert wedge variant of a spinaljack according to the present invention;

FIG. 78 is a lineal cutaway of the rear insert wedge spinal jack in afirst retracted position, prior to insertion of a ramped and expandingkey portion, and which illustrates a sloped inner boundary establishedbetween the upper and lower cam halves in combination with guide andslot engagement;

FIG. 79 is a succeeding lineal cutaway to that presented in FIG. 78 andshowing the key portion in inserted and seated fashion between the upperand lower cam halves, concurrent with the upper and lower halves beingoutwardly relatively displaced to an expanded position;

FIG. 80 is a further variation of a rear insert wedge lift incorporatedinto a further modified variant of clamshell designed spinal jack withrear living hinge;

FIG. 81 is a succeeding inserted position of the wedge lift of FIG. 80in an inserted and outwardly expanded condition;

FIG. 82 is a cutaway illustration of a further variant of jack liftalong the general principles of the previous variant in FIG. 26 andshowing an inner displaceable wedge component seated within a planarinner base surface of a lower jack half and arranged in stepped/serratedengagement with an inwardly facing boundary of an assembled upper jackhalf;

FIG. 83 is a modification of the jack lift of FIG. 82 which illustratesa bit receiving portion associated with and extending from the wedgecomponent outside of the upper and lower assembleable halves and whichis engaged by an inserting tool for assisting in stepped outerdisplacement of the jack halves;

FIG. 84 is a crosswise cutaway illustration of a further example ofspinal jack according to any one of a number of alternate configurationswith assembleable upper and lower jack halves, and further showing atool with inwardly opposing and offset bit portions which align with andare received by a pair of like offset and inwardly displaceable wedgeportions associated with the spinal jack;

FIG. 85 is a succeeding illustration to FIG. 84 and showing the toolinwardly displacing the wedge portions into a central alignedconfiguration consisting with suitable configurations between the upperand lower jack halves causing outward expanding displacement;

FIG. 86 is a successive crosswise illustration of a modified jack insertand showing a pair of spaced apart insert portions which are positionedin an initial and pre-expanding condition relative to an alternatestepped configuration established between upper and lower jack halves;

FIG. 87 is a succeeding displaced illustration to that shown in FIG. 86and by which the concerted outer lineal displacement of the bit insertportions corresponds to lateral edge directed displacement of coactingramped portions associated with the boundary established between theupper and lower spinal jack halves, resulting in outward relativedisplacement of the jack halves;

FIG. 88 is an environmental illustration of an assembleable jack braceaccording to a further embodiment and which includes individual windowlocations corresponding to seating and supporting displacement ofarticular processes associated with succeeding vertebrae;

FIG. 89 is a further and related environmental illustration of a jackbrace such as shown in FIG. 88 and which is designed for supporting aplurality of three succeeding vertebral processes;

FIG. 90 is a lineal cutaway illustration of an assembleable spinalprocesses brace such as illustrated in FIG. 88;

FIG. 91 is a cutaway illustration of a further succeeding variant ofspinal process supporting brace and showing first and second sideengageable plug fasteners arranged in intermediate inserted and preseating/locking positions relative to an inwardly notched interfaceassociated with a pair of outer seating sleeves associated with a sideassembleable half and which receives aligning and coaxially insertinginner sleeve portions associated with the other side assembleable half,the inner male portions likewise being interiorly hollowed to facilitateinsertion of the plug fasteners;

FIG. 92 is a successive cutaway illustration to that shown in FIG. 91 inwhich the plug fasteners are fully seated within the opposing andcoaxially engaging inner and outer pairs of sleeves;

FIG. 93 illustrates in exploded fashion an assembleable spinal processjack brace such as shown in FIG. 89;

FIG. 94 further illustrates the jack brace of FIG. 93 in an assembledconfiguration;

FIG. 95 illustrates a two process spinal brace such as shown in FIG. 88with first and second side assembleable halves;

FIG. 96 is an illustration of a further variant of spinal process bracein a first retracted position and which exhibits linearly expandableupper and lower halves;

FIG. 97 is a succeeding illustration to that shown in FIG. 96 and inwhich the upper and lower brace halves are relatively outwardlydisplaced;

FIG. 98 is a lineal cutaway illustration of the brace shown in FIG. 96and showing the inner and linearly expansive spring arrangementestablished between upper and lower jack halves in the first retractedposition;

FIG. 99 is a successive lineal cutaway of the brace shown in FIG. 96 andin which first pairs of opposite/lateral positioned and outwardly springbiased portions associated with an intermediate supporting portion aresimultaneously inwardly displaced, resulting in additional linealextending pairs of spring loaded portions arranged between opposite endsof the supporting portion and inner facing end pockets of the upper andlower brace halves, thus causing relative outer displacement of thebrace halves at their boundary interface and relative to the innersupporting portion, the supporting portion exhibiting additional pairsof outwardly spring biased seating portions which reseat within aperturelocations revealed by inward displacement of the first pairs of springbiased portions and concurrent with the upper and lower brace halvesachieving their desired maximum expanded position relative to the innersupporting portion;

FIG. 100 is a perspective view of a further modified and generally “H”shaped spinal brace assembly in a first retracted position including acentral assembleable and process defined support, with upper and lowerpairs of outwardly displaceable vertebral engaging portions; and

FIG. 101 is a succeeding view to FIG. 100 and showing the feature of apair of central side positioned and inwardly displaceable buttonportions which are linkage connected to the upper and lower pairs ofoutwardly displaceable portions to cause the same to abut opposingsupport surfaces associated with a given pair of succeeding vertebrae.

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

As will be described throughout the following detailed description, thepresent invention discloses a variety of ergonomically fitting andelevating jack inserts, such as for insertion between succeeding lowerlumbar vertebrae but not limited in application to any locationassociated with a spinal cord. In combination with selective cushioningimplants and/or additional supporting/reinforcing structures establishedbetween the vertebra, such as including process supporting bracingassemblies, the elevating jack inserts operate to establish a desiredvertical and dynamic spacing support (as well as also providing degreesof lateral/torsional support) between specified vertebra.

The provision of the insertable/elevatable jack inserts and processsupporting braces as described throughout the succeeding views alsoserves to prevent pain to the user, such as resulting from the pinchingor contacting of nerves in the spinal column and due to spinal columnmisalignment, scoliosis and the like. Also, and while again not limitedto any specific vertebral installation, the various jacks and bracinginserts disclosed herein are particularly applicable to lower lumbervertebrae which will be illustrated in a number of the views providedherein.

As are also known in the prior art, lower lumbar vertebrae are thelargest segments of the movable part of the vertebral column, and arecharacterized by the absence of the a foramen transversarium (thisforming a portion of other spinal vertebrae most typically associatedwith the main thoracic vertebrae). Lower lumbar vertebrae are designatedL1 to L5, starting at the top, and are very robust in construction, inthat they must support more weight than other vertebrae associated withthe spinal column. The lower vertebrae allow significant flexion andextension, moderate lateral flexion (sidebending), and a small degree ofrotation. The discs between these vertebrae additionally create a lumbarlordosis (curvature that is concave posteriorly) in the human spine.FIG. 3 is an illustration of a human spinal column according to theprior art and identifying the various types of spinal vertebraeincluding the atlas cervical 1, axis cervical 2, main cervical 3,thoracic 7, lower lumbar 5, sacrum 6 and coccygeal 4.

Typical vertebra consists of two essential parts: an anterior (hunt)segment, which is the vertebral body; and a posterior part, otherwiseknown as the vertebral (or neural) arch which encloses the vertebralforamen. When the vertebrae are articulated with each other, the bodiesform a strong pillar for the support of the individuals head and body(or trunk). As is also known, the vertebral foramina (or bone aperture)constitutes a canal for the protection of the medulla spinalis (orspinal column). In between every pair of vertebrae are two apertures, anintervertebral foramina exists, one on either side, for the transmissionof the spinal nerves and vessels.

Applying the above general explanation, a description will now follow ofthe several variants of spinal column jacks and spinal process supportbraes employed with any inter-vertebral interfaces, including againspecifically lower lumbar vertebrae, and which function to provide adesired degree of supported and inter-vertebral spacing betweensucceeding vertebrae in order to establish dynamic support withinlimited ranges of motion. Advantages associated with the spinal jacksand braces includes the ability to install and maintain the componentsin any desired position relative to any number of vertebrae (as well asto install in a much less invasive fashion than associated withvertebral fusing plates of titanium and the like), this further such asto avoid pinching of spinal nerves associated with the spinal column aswell as compensating for other structural misalignments in the spine,such as resulting from scoliosis or other deformities.

As will be further described in reference to the numerous succeedingviews, a non-limiting objective of the present inventions is inproviding for significantly less invasive inter-vertebral support atdesired locations. This again, while retaining a desired (usually minor)remaining degree of inter-movable support between the associatedvertebrae, allows for much greater range of motion than associated withabsolute fusing or fixing techniques further associated with prior artfixed titanium plates and the like.

The above said, and referring now to FIG. 1, a front plan view isgenerally shown at 10 of a first installation arrangement of a humanspinal location including such as a plurality of three consecutive lowerlumbar vertebrae and in which a spinal insert jack, further generallyshown at 12, seats in abutting fashion between opposing and central bodylocations of a selected pair of the lumbar vertebrae. Also shown inaddition to the central insert jack 12 is the provision of a pair ofsecondary auxiliary jack supports, at 14 and 16, these being supportedbetween opposite and spaced apart pairs of transverse process portions,see at 18 & 20 and 18′ and 20′, associated with succeeding lumbarvertebrae 22 and 24, these also constraining therebetween the generallycentrally positioned jack 12.

The main vertebral body of each lumbar vertebra, further shown at 26 forvertebrae 22 and at 28 for vertebrae 24, exhibits is enlarged relativeto the other types of spinal vertebrae (see again FIG. 3) and is widerfrom side to side than from front to back, as well as a little thickerin front than in back. The vertebrae are also flattened or slightlyconcave above and below, concave behind, and deeply constricted in frontand at the sides.

Referring again to FIGS. 1 and 2 in combination, the central installedspinal jack 12 and peripheral located auxiliary jacks 14 and 16 are eachmaterial constructed (without limitation) from such as a sanitaryplastic or metal material, or admixed composite thereof. As is alsoshown in FIG. 2, the spinal jack insert 12 exhibits a two piece bodyconstruction, including an ergonomically configured upper piece 30 (seeconcave inner exposed profile 31) and an inter-assembled lower andlikewise configured piece 32 (this further including a like concaveinner profile 33).

As will be described in additional detail with reference to thesucceeding variants of the two piece jack, and upon pre-locating thejack 12 such as in the inter-vertebral process location identified inFIG. 1 and by which the opposing concave surfaces 31 and 33 seatopposing profile surfaces of upper and lower illustrated superiorarticular processes 27 and 29, a key tool portion (not shown in thisview) is inserted into a key location, see at 34 in each of FIGS. 1 and2, defined in a central actuating location of the jack body. As bestshown in FIG. 2, each of the upper piece 30 and lower assembled piece 32further include aligning and overlapping extending portions, see furtherat 37 and 39, these further exhibiting opposing pluralities of serratedteeth (see at 37′ and 39′ respectively for aligning/overlappingextending portions 37 and 39) and which is communicated by the key 34.The key 34 typically includes an inner engaging portion which seatsselected teeth 37′ and 39′ and, upon being rotated by the external tool,results in separating displacement of the upper 30 and lower 32 pieces(see arrow 35 in FIG. 2), this corresponding with a desired spacing tobe established between the lumber vertebrae 22 and 24 and typicallyfollowing the jack 12 being pre-located in its desired inter-vertebralenvironment as shown in FIG. 1.

As again illustrated in the variant of FIG. 1, the main jack 12 isseated within an open spaced defined between vertebral body portions 26and 28 (this generally defined as being an open area existing betweenopposing spinal disc annulus associated with each vertebrae). Alsoprovided are a pair of arms 36 and 38, these extending laterally fromthe upper body portion 30 and engaging projecting locations of a givenvertebrae interface (such as understood to include mamillary processportions 40 and 42 as referenced in FIG. 1).

In cooperation with the main/central jack 12, the secondary/auxiliaryjack supports 14 and 16 are secured between the transverse processportions 18 and 20 of the succeeding lumbar vertebrae 22 and 24. Theauxiliary jacks 14 and 16 each include intermediate extending and stemshaped bodies, of which opposite and arcuate (or cup shaped) ends engageassociated locations of the selected process portions 18 and 20 of thelumbar vertebrae 22 and 24.

As with the central and main jack 12, each of the auxiliary jacks 14 and16 includes a key insert location, see at 44 and 46 respectively in FIG.1 and which, upon being accessed by a suitable key (also not shown inthis view), operates to adjust an overall length of each of theauxiliary/secondary jacks 14 and 16, thereby achieving a desired spatialand supporting arrangement of the spaced apart process portions 18 and20 in cooperating fashion with the biasing displacement provided by thecentrally inserted jack 12. As is also shown in FIG. 1, a centrallyextending spinal cord 48 associated with the patient includes branchingsets of nerves 50 and 52, the arrangement and configuration of the mainspinal jack 12 and auxiliary jacks 14 and 16 being such that they do notinterfere with the arrangement of the spinal cord and nerves relativethe spinal column.

As will also be disclosed in reference to succeeding embodimentsthroughout the description, it is also envisioned that the main jack 12and auxiliary jacks 14 and 16 can be anchored to either or both of thesucceeding vertebrae by any collection of drill hole and insertablefasteners, ring supports and the like. It is also envisioned that theexposed jack surfaces (such as again the concave patterns 31 and 33referenced in FIGS. 1 and 2) can also employ any desired textured orundercut pattern which promotes the generation and adhesion of naturallyoccurring bone marrow between the inserted jack and the mountingsurfaces of the spinal vertebrae, such marrow generation/adhesion beingused additional or alternative to any one of a plurality of possiblefastening schemes.

Referring now to the side view of FIG. 4 and succeeding rear view ofFIG. 5, generally shown at 54 are a pair of succeeding lower lumbarvertebrae 56 and 58, and illustrating one potential arrangement andvariation of an elevating jack insert with a central stem 60establishing a generally elongated shape and which is installed betweenspaced apart superior articular processes 62 and 64 associated with thevertebrae 56 and 58. The jack is similar in regards to the design of theauxiliary jacks 14 and 16 in FIG. 1, in that it provides each of a pairof opposite vertebral (inwardly cup or arcuate shaped) engaging endportions, see at 61 and 63.

As shown in FIG. 5, the end portions 61 and 63 are seated in displacedand separating fashion relative to the central and intermediate stem 60,such that an overall length can be modified with the implementation of akey (see portion 65 defined in sleeve 60 and operating in similararrangement to that illustrated and described previously in relation toauxiliary jacks 14 and 16) in order to extend the overall length of thejack 60. Otherwise, the jack 60 is similarly configured as previouslyshown at 14 and 16, with the exception in this instance that it isenlarged and reinforced to operate as the main supporting and separatinginsert at an inserting location between the selected superior articularprocesses of the spinal vertebrae 56 and 58, these extending rearwardlyin the manner illustrated in FIGS. 4 and 5 from a forward location ofthe vertebral bodies.

FIG. 4 also illustrates a forward located and fluid filled cushioninginsert 66 (see also side and rotated top inset views of FIGS. 4A and 4B)which is disposed between the main/central body portions associated witheach of the vertebrae 56 and 58. The cushion inserts 66 are illustratedas exhibiting a solid ring shape exterior (such as constructed of aselected softened/lubricating/antibiotic plastic rating), within whichis contained a liquid (or other fluidic/gelationous) mixture of softerplastic and typically also antimicrobial material according to anydegree of three dimensional size or internal pressurization, see cushion68 encircled by the outer plastic ring 66, and for establishing thedesired cushioning properties when installed in the open spaceestablished between the succeeding vertebrae 56 and 58.

Clips 67 and 69 are shown in FIG. 4 and are typically constructed of aflexible plastic or like material which engage, such as by undercutdrilled recesses or the like, main body locations of each succeedingvertebrae. The clips 67 and 69 can exhibit any desired properties offlex and are mounted in connecting fashion between the succeeding lumbarvertebrae to assist in maintaining in interiorly positioned fashionbetween the vertebrae 56 and 58, the harder outer ring 66 and softerinner supported cushion 68.

As again shown in FIG. 6, the extending portions 61 and 63 respectivelyexhibit cup shaped ends which 70 and 72, respectively, define a softest(lowest durometer) rated plastic, with the intermediate extending stem60 further defining a more rigid (intermediate durometer) plastic. Arigid interior is contained within the stem 60, and which can includesuch as one or more overlapping rods, see at 74 and 76, these associatedwith the extending portions 70 and 72 and further being of a highestrated durometer (most rigid material). The keyway access point, see aspreviously shown at 65 again can include an interior rotatable engagingfeature for displacing the rods 74 and 76, such as upon receipt of aninsert portion of a tool (not shown) which is then rotated, such asalong directional arrows 78, in order to separate rods 74 and 76 andassociated end positioned rods 70 and 72 outwardly relative to the stem60 and until they abut the spaced apart articular processes 62 and 64(again FIG. 5) in a fashion that the spinal vertebrae is supported in adesired spatial arrangement.

FIG. 7 illustrates, generally at 80, a rotated side view of a furtherengagement relationship of a set of ballasting inserts 82 and 84established at distinct locations between a pair of succeeding lowerlumbar vertebrae 86 and 88. The ballasting inserts 82 and 84 exhibitsimilar cushioning properties in comparison to the cushion 68 associatedwith outer ring support 66 in FIG. 4 and, in the current illustration,are positioned at first and second locations relative to the interfacingarchitecture of the lower lumbar vertebrae 86 and 88. As shown, thefirst insert 82 is positioned at a generally forward location relativeto the central portions of the vertebrae 86 and 88, whereas the secondinsert 84 fits between the spacing established between superiorarticulating process locations, see as further shown at 90 and 92,associated with the spaced apart vertebrae.

Also shown in FIG. 7 are the provision of forward and side installedretaining clips, see as identified at 94 and 96, these assisting inretaining in place the inserts (with reference to selected insert againshown at 82) and so that the same does not move or otherwisedisplace/slip out of desired position following installation. The clips94 and 96 are similar in construction as those previously described at67 and 69 in FIG. 4, such as which are constructed of a durable plasticand selected ones of which may exhibit desired flexural properties.Alternatively, the designs of the clips may further be such that thatthey may be adjustable in length and/or tension (see connecting portion98 associated with conjoined pair of forward positioned clip 94) toachieve a desired degree of give and bend depending upon a desiredapplication.

Referring now to FIG. 8, a rotated side view is shown at 100 of aselected pair of lower lumbar vertebrae 102 and 104, and further showinga two piece elevating jack insert 106 according to a furtherconfiguration asecured between respective superior articular processes108 and 110 of the vertebrae according to a further preferredembodiment. As is described in a number of applications herein, the jack106 exhibits a two piece ergonomically configured and plasticized body(such as exhibiting process receiving concave surfaces such aspreviously shown at 31 and 33 in the example of FIG. 2) and which,following installation, is expandable to achieve a desired separationdistance between a pair of the lumbar vertebrae. As further shown at112, one or more arms or clips extend from the jack 106 to secure thesame to a given location associated with either of the lumbar vertebrae.As further again shown at 82, an cushioning style insert with softplastic consistency and bias-able construction is again provided and inorder to maintain a desired spacing of the vertebrae 102 and 104.

FIG. 9 is an illustration generally shown at 112 of a two piece spinalvertebrae jack insert exhibiting first 114 and second 116 extending andundercut engaging support arms, as well as surface located undercut(contact) teeth (see at 118 and 120 applied over concave ergonomicsurfaces associated with each of the upper and lower body portions) andfor positionally locating and restraining the jack 112 whenpre-installed at the desired location between succeeding lower lumbar orother specified vertebrae. A keyway adjusting location is generallyreferenced by rotatable input location 122 and, when engaged by asuitable tool, outwardly displaces the upper and lower body portions inthe manner shown and such as in an expanding direction indicated bybi-directional arrow 123.

FIG. 10 is a corresponding illustration of a two piece elevating spinalinsert jack, see generally shown at 124, according to a further possiblevariant and which again illustrates a pair of undercut arms 126 and 128extending from a first upper piece 130 (similar to that shown at 114 and116 in FIG. 9), as well as a pair of mounting pins 132 and 134 extendingfrom a second interconnected lower piece 136, these for securing thejack 124 in place. As will be further described, the mounting pins canalso exhibit a flexible/arcuate profile and can further include aserrated/undercut engaging end, see as further described in reference toFIGS. 42-44, for fixedly anchoring into a designated bone location ofthe associated vertebrae.

A key receiving and separating portion is again referenced by rotatablecomponent 138, this likewise including an interiorly extending portionwhich engages opposing and serrating edges of inner aligning andoverlapping extending portions, again at 135 and 137, associated withthe upper 130 and lower 136 assembled and expandable pieces. The jack124 operates under the same principle as described above in relatedvariants of FIGS. 2 and 9 for separating the halves of the plasticized(or other suitable material constructed) jack to exert a suitable anddesired separating force between the abutting locations of the lowerlumbar vertebrae upon installation.

Referring now to FIGS. 11-14, a further variant, generally at 140, isshown of a two piece expandable spinal insert jack, this including upperergonomically configured piece 142 and lower likewise ergonomicallyconfigured piece 144. The upper configured piece 142 can include atapered and overlapping lower edge 146 relative to the assembled lowerpiece 144 and, as shown in the several environmental applicationsalready described, the jack 140 is installed at a desired locationbetween configured portions of succeeding lower lumbar vertebrae, thepurpose again being to establish a secure and desired spacing betweenthe vertebrae.

As shown in the assembled view of FIG. 11, the upper piece 142 and lowerpiece 144 each exhibits a desired recess configuration (see at 148 and150, respectively) for assisting in seating the jack 140 between thevertebrae. The central body portions of each of the upper piece 142 andlower piece 144 exhibit a moderate to hardened plastic durometerconstruction. As further shown, uppermost 156 and correspondinglyopposite lower most 158 contact locations of both the upper piece 142and lower piece 144 exhibit a softer durometer construction, thisintended to contact and abuttingly engage the opposing surfaces of thevertebrae in use. As will be reference in succeeding embodiments, it isfurther understood that both the upper and lower recessed abuttingsurfaces can further exhibit teeth surfaces, ridged patterns or thelike, all of which are intended to assist in frictionally engaging thejack insert 140 in place.

Proceeding to FIG. 12, a tool 160 is illustrated for engaging a jackinitiating keyway location 162 associated with the two piece spinal jack140. FIG. 13 illustrates a rotated and underside perspective of thespinal jack of FIG. 11, with both the underside recess configuration ofthe selected jack portion as well as the provision of a plastic or metalscrew 164 extending through a recess profile location 166 in the lowerpiece 146, such as for mounting the jack to a lower vertebral location.

FIG. 14 is an illustration of the lower piece 144 of the spinal jack(the top elevating portion being removed) and showing the feature of thebeveling arrangement for lifting the upper piece upon implementing thetool 160. As shown, a first (bevel initiating) screw drive component isshown at 168, this being stationary rotated within the architecture ofthe lower body 144 by the implement tool 160. A second component 170extends in a crosswise/height-wise direction and is further configuredwith an exterior screw pattern which is actuated in a bevel like fashionupon rotation of the first stationary component 168, and so that thesecondary component 170 abuts and then elevates the upper piece 142 in achanneled and separating fashion relative the lower piece 144, so thatthe pieces 142 and 144 establish a desired spacing and without thembecoming disassembled. As again shown in FIG. 14, the interiorarchitecture of the lower piece 144, see interior annular supportlocation 172 which is connected to outer displaced inner wall 174 by weblocations 176 and 178, defines a support surface for the verticaldisplacement of the secondary lifting component 170.

As previously described, the inner (both working and structurallysupporting) components of the assembleable halves are of a harderdurometer rating, and as compared to the outermost (see 152-158 surfacelocations of the pieces in FIG. 11, these again exhibiting varied softerto intermediate durometer ratings based upon location). A furtherseating aperture 180 is shown in the open underside view of FIG. 14 andwithin which can be seated a finger or other stem portion associatedwith the assembled and vertically actuated first piece 142 (again notshown in FIG. 14), thereby further assisting in preventing the piecesfrom becoming separated or misaligned.

Referring now to each of FIGS. 15-33, a series of front plan cutawayillustrations are shown of varying mechanical or fluidic liftconfigurations associated with a two piece spinal jack, such as shown inthree dimension in FIGS. 11-14. For purposes of ease of description,identical components will not be repetitively illustrated in each of thefollowing illustrations, rather discussion will be limited to thestructurally distinguishing components of each variant with a generalunderstanding that the design and construction of each jack can, in onenon-limiting application, generally replicate that shown in theembodiment of FIG. 11.

Referring to FIG. 15, a front plan line art cutaway of a screw lift wormgear configuration incorporated into a two piece spinal vertebraesupported and elevating jack 182. As shown, a drive worm gear 184 isactuated in order to rotate a drive lift gear 186 which is seated inguided rotational fashion by a pillar extending portion 187 associatedwith a lower portion of the jack, and which in turn coacts with andelevates an interior stem portion 188 integrally formed with an upperelevating and configured portion 190 of the jack 182. Although not shownin the two dimensional cutaway, the rotating gear 186 and coaxiallyrestrained stem 188 each exhibit mating and aligning threads tofacilitate expansion.

FIG. 16 is an illustration of a jack design 192 similar to that in FIG.15, and further depicting a screw lift bevel gear. A side disposed drivegear is shown at 194, in substitution for the drive worm gear 184 inFIG. 15. Otherwise, the features of the lift gear 186 and stem portion188 remain as described in FIG. 15 and such that, upon rotation of thegear 194 from a side exposed illustration, coacting rotation of drivelift gear 186 is transferred to mating threads associated with interiorstem portion 188.

FIG. 17 is an illustration generally at 196 of another jack variantemploying a screw lift ratchet, in particular employing a lever or pushratchet gear 198, and for again operating the lift gear 186 and stemportion 188. The ratchet gear 198 is engaged, such as in a rotatingdirection 199 as shown, and in order to transfer a drive input to thestem portion 188 via the lift gear 186.

FIG. 18 is an illustration at 200 of a screw lift put in place jack andshowing spiral stem threads 202 extending from a top piece 204, theseseating within internally defined threads 206 associated with areceiving base collar 207 associated with the base piece 208. Unlike anumber of prior variants, the screw lift put in place jack 200 iselevation adjusted by rotating the top piece relative to the base piece208, without the need for extraneous tools, for readjusting an overallseparating distance between the upper and lower opposing recessedseating surfaces of the pieces.

FIG. 19 is an illustration at 210 of a rack gear pinion lift jack, andshowing a rotating pinion gear 212 fixed in axially supported fashionand so as to extend within an interior of a lower jack piece 213. Aninwardly extending stem 214 is secured to an upper piece 215 andexhibits inwardly facing teeth, these engaging the rotating gear 212and, in response to a side bit engaged rotatable input (not shown) forheight readjusting the upper piece relative to the lower piece.

FIG. 20 is an illustration generally at 216 of a rack gear ratchet liftjack, see lever or push ratchet 218, this being selectively actuated toredefine an elevated height of an upper piece 217 (see exterior serratedface 220 of extending stem) relative to the lower piece 219. Similar tothe variant of FIG. 17, the lever/push ratchet 218 is mounted inrotatable fashion, such as to an inward projecting support 221associated with an upper side wall location of the lower piece 219 andis actuated to transfer a lifting component imparted to the inwarddisposed ratchet teeth 218′ for successively elevating and reseating theengaging teeth associated with the serrated face 220 of the stem.

FIG. 21 is an illustration of a jack 222 employing a step slot springlift configuration, and for achieving elevation of the upperergonomically configured piece relative to the lower piece. A lockingscrew 224 is employed within a pair of upper and lower body definedslots (see as collectively shown at 226) these being defined along theinterior stem. Outer positioned compression springs, see at 228 and 230,and such that, upon the constant separating force exerted by the biasingsprings defining a desired separation distance between the upper andlower pieces (this such as after the unit being installed in placewithin the lower lumbar vertebral environment), the locking screw 224 isengaged (such as again through a bit engaging portion extending throughan exposed side location of the lower body half) to tighten the bodyhalves in place.

FIG. 22 illustrates at 232 a modification of FIG. 21 in that a step ringspring lift jack, in the form of a rotating step ring 234, is employedto define a height interaction between the upper 233 and lower 235halves, this in substitution for the aligning body slots 226 of FIG. 21and which is interposed by locking screw 224. In FIG. 22, the outwardbiasing forces exerted by the springs 228 and 230 combine with thestepped pattern established between the stem engagement locations (seeat 236 and 238), this being acted upon by the rotation of the step ring234 so that the seating portions (shown at 237 and 238 and which areintegrally formed with the bottom of stem 239 associated with theexpandable upper piece 233) is caused to upwardly reseat in a ratchetdefined manner and in order to redefine a subset number of heightestablishing positions between the jack halves.

FIG. 23 is an illustration generally at 240 of a screw scissor lift jackarrangement An internal and crosswise extending screw, see at 242, ismounted within a substantial midpoint location of the jack 240. An upperpiece 241 is secured to lower piece 245 by a downwardly extending stem243, the actuation of the screw 242 causing upper spring portions 244and lower spring portions 246 to biasingly deflect, and thereby to causethe stem 243 to vertically actuate in the fashion illustrated. The pullscrew 242 is linearly retracted from the housing at the location shownat 248, this causing the compression of the pairs of spring portions 244and 246 to raise and lower the upper jack half 241.

Referring now to FIG. 24, an illustration is generally shown at 250 of acam lift ratchet lock jack variant. A lower half 251 of the jack againincludes a receiving sleeve with inwardly facing serrated portions 252.A ratcheting arrangement is established between the inwardly facingserrated portions 252 and opposing outward serrations 253 defined upon adownwardly extending stem portion 254 associated with upper half 255. Acam 256 is rotatably mounted in crosswise fashion between inner sidewalls associated with the lower jack half 251 and seats at a locationapproximate a bottom surface 258 of the lower half inner pocket. A tool(not shown) is employed to rotate the cam 256, and so that it's profilededge upwardly biases and displaces the upper body 255 via its stemportion 254. This is further caused by the ratcheting upwarddisplacement of its serrated portions 254 relative to the inwardlyfacing serrations 252 of the lower half receiving sleeve (and furtherconcurrent outward deflection of the walls associated with the lowersleeve (see at 252′) which can further be designed so as not extendabout an entire interconnected perimeter and which allows, via itsoutward biasing deflection and subsequent retraction, to elevate the tophalf 255 relative to the bottom 251.

FIG. 25 is an illustration generally at 260 of a push in wedge blocklift jack variant, and by which both the upper 261 and lower 263 jackhalves exhibit interiorly extending boundary defining andangled/converging opposing edges 262 and 264, each of these furtherexhibiting serrated (locking) teeth. A wedge block 266 is laterallyinserted through a side disposed opening in the lower jack half, theblock 266 exhibiting a forward tapered end exhibiting additionalserrations 267 which, upon laterally displacing the wedge blockinwardly, co acts against the opposing tapered profile defined by theserrated edges 262 and 264, thereby upwardly displacing the upper jackhalf 261 a desired distance.

FIG. 26 is an illustration generally at 268 of a further variant of ascrew wedge block lift jack, this similar in concept to the variant ofFIG. 25 and by which the nestingly engaged upper jack half 269 includesan inner and downwardly downwardly extending body terminating in anangled serrated edge 270. A pull screw 272 extends through the open baseof the lower jack half 271, a further wedge block 274 displaceablysetting upon an interior base surface 273 of the lower half 271 andengaging an extending end of the pull 272. The displaceable wedge block274 exhibits a further plurality of upwardly disposed serrations 276defined on an angled or tapered upper surface of the block 274 and whichare in angular/co-acting contact with the downwardly facing teeth 270associated with the interior and downwardly extending stem portionassociated with the upper jack 269. Upon, pulling the screw 272outwardly from the lower jack half body 271, the wedge block 274 islaterally displaced (via directional arrow indicated) and, upon itsteeth 276 coacting with the downwardly facing teeth 270, causes theupper jack half 269 to upwardly displace.

FIG. 27 is an illustration, generally at 278, of a pump lift aircompress lift jack variant, this employing a combination of fluidactuating upward lifting, combined with mechanical ratchet engagementbetween coacting portions of upper 279 and lower 281 jack body halves.In particular, an air injection hole 280 communicates through the lowerjack half 281 to an inner pocket location (at 283) defined withinupwardly extending sleeve walls 282. The upper jack half includes adownwardly extending stem 284 sealingly engaging within the innerpocket.

The upper jack half 279 also includes an outwardly co axially spaced anddownwardly extending annular wall, see at 286, this further exhibitingan inner annular extending tang 288. The lower jack 281 includes, on theouter facing annular surface of the walls defining the inner annularpocket, a further series of serrations 290. Upon applying a remotepressurized source (not shown) into the air injection hole 280, pressurebuilds at the open bottom of the pocket 283, causing the stem portion284 to upwardly displace from the pocket, this concurrently causing theinwardly facing tang 288 to ratchet engage each of the exteriorlyfacing/vertically disposed serrations 290 of the lower jack annularpocket wall, and to thereby establish progressively achieved and secureelevating locations.

Referring now to FIG. 28, an illustration is shown at 292 of a relatedteaching to that illustrated in FIG. 27, and further discloses a pumplift filler plastic lift jack. Similar features again include aninjection hole 294 defined in lower jack half 293 (this providing apressurized conduit for a flowable/filler plastic and as opposed to airpressures as in FIG. 27). The injection hole 294 communicates throughthe lower jack half 293 to an inner pocket location 295 defined withinupwardly extending sleeve walls 296.

Upper jack half 297 includes a downwardly extending stem 298 sealinglyengaging within the inner pocket 295. The coaxially spaced outer wall286 in FIG. 27 is not employed in the variant of FIG. 28, rather thebiasing and supporting pressure caused by the flowable/molten fillerplastic (not shown) causes the upper jack half to upwardly displace in asecure supported fashion (this again assisting in establishing a secureseating environment when employed within the lower lumbar vertebraeenvironment).

Referring now to FIG. 29, an illustration is generally shown at 300 ofanother relative fluid pressure actuated variant, in this instance beinga pump lift hydraulic jack including a lever piston pump 302 (this insubstitution for the plastic injection hole 294 in FIG. 28). The lever302 is reciprocated within a cylinder pocket 304 defined in the lower(base) jack half 305, this in turn building pressuring within aninterior and stem supporting pocket 306, within which is sealinglysupported the upper jack half inserting stem 308. Upon achieving adesired interior pressure, an upper jack half 309 is caused to upwardlydisplace and so that the opposing recess configurations of both theupper 309 and lower 305 jack halves biasingly engage the desired seatinglocations of any select pair of lumbar vertebrae.

Referring now to FIG. 30, an illustration is generally shown at 310 of aballoon ring filler plastic lift jack, this comprising a separatecomponent which is placed within an interior pocket defined between theupper and lower jack halves, such as according to any of the embodimentsdescribed herein. The balloon ring filter plastic lift includes an outerannular hard plastic ring construction 312, to which are secured upper314 and lower 316 softer membranes. A fluid pressure (e.g. air)injection hole is shown at 318 and, upon pre-positioning the membranewithin the jack interior pocket, the injection hole 318 is communicatedwith a further aperture (not shown) defined in the lower jack half andso that, upon communication of the exterior pressurized source, themembrane is caused to inflate, primarily in the direction of the upperand lower membranes, and so that the associated stem portion of theupper jack half causes it to displace upwardly.

Referring to FIG. 31, an illustration is generally shown at 320 of afurther configuration of a balloon shaped filter plastic lift jack, andby which a three dimensional membrane 322 is interposed between opposingand spaced apart surfaces of upper and lower jack halves. The membrane322 again includes a hardened outer annular ring 324, to which are againengaged upper 326 and lower 328 softer membranes in order to create athree dimensional sealed interior. The upper and lower jack halves (theopposing edges of which are respectively identified at 332 and 334) aresecured attached at their spaced distances via the hardened ring 324. Afilter plastic injection hole 330 is again provided and, uponcommunicating a flowable/settable plastic from an exterior source,causes the upper and lower softer membranes to inflate, and so that theyrespectively outwardly displace an upper most configured edge 336 of theupper jack, this exhibiting a soft membrane with stiffenedreinforcement, as well as a lower most configured edge 338 againincluding a soft membrane material with stiffened reinforcement which isassociated with the lower jack.

FIG. 32 is an illustration generally at 340 of a pinch lift spinal jackaccording to a yet further variant. According to this variant, a pair ofinwardly facing and opposing wedge blocks, see at 342 and 344, separateupper 346 and lower 348 jack halves, the jack halves exhibiting opposingstep lock (angled) surfaces as further shown at 347 and 349,respectively. A flexible membrane, as shown at 350 in two dimensionalcutaway, encircles a perimeter of the jack halves, in supporting fashionover the wedge blocks. A plier tool or like implement is employed toactuate, such as by inwardly depressing, the wedge blocks, resulting ininward convergence of the blocks thereby creating additional separatingdisplacement between the jack halves (see arrows 351 and 351′), theouter membrane 350 flexing in response to outward displacement betweenthe jack halves.

FIG. 33 is a general illustration of a related variant 352 to that shownin FIG. 32 and by which a single laterally displaceable wedge block 354is employed and engages an end stop 356 defined at a side wall locationof a modification 358 of the lower spinal jack half, the upper jack halfagain being as shown at 346 in FIG. 32.

Referring now to FIGS. 34 and 35 a-b, illustrated are respective end andfrontal plan view illustrations of an eccentric/oval shaped element 360,such including an exterior and generally oval/elliptical profile 362 andalso exhibiting an encircling concave pocket (see elliptical innersurface 364 in FIG. 35B) for seatingly engaging opposing vertebrallocations. The oval shaped element further exhibits a biasinglydeflectable open interior defined by the inner surface 364 (see FIGS. 35a and b) for providing a measure of cushioning and resilient support,this occurring upon such as upon rotating the pre-located body (in FIG.35 a and by which the lengthened sides abut against opposing innersurfaces of succeeding vertebrae) to an upwardly disposed and maximumelevation (in FIG. 35 b and by which the vertebrae are biased in adesired spatial fashion). The oval shaped element further includes apair of pins or screws, shown at 366 and 368, these typically arrangedat 45° offset locations, for securing to the vertebrae in its finallocation in order to prevent slippage. Reference is made again to FIG.35 a which illustrates the pre-insertion and post-rotation directions ofthe oval shaped element, and in order to achieve the desired finalvertebral repositioning configuration of FIG. 35 b.

FIG. 36 is an illustration 370 of an inboard lift ball configuration andby which first and second lift components 372 and 374 are relocated tointerior and opposing locations between a pair of processes 376 and 378associated with succeeding lumbar vertebrae. The lift components arerelocated to an inner location proximate the spinal cord and nerves (seeagain FIG. 1) extending through the vertebrae.

FIG. 37 is a succeeding illustration 380 to that shown in FIG. 36, andby which the lumbar vertebrae are separated by virtue of a pliers toolutilized for manipulating an insert ball 382 contained between theinter-engaged lift components 384 and 386. The insert ball 382 isinserted between the spaced components and, at that point, a lock ring388 is rotated to maintain the spaced relationship establishedtherebetween.

FIG. 38 is an illustration 390 of a succeeding embodiment, and by whichan alternatively configured pair of upper and lower vertebrae supportinglift components 392 and 394 are arranged at locations similar to thoseshown in FIG. 36. A pair of lift pliers are again employed to repositionan upper vertebra supporting component 392, this including an outersleeve which seats over an inner stem associated with the lower vertebrasupporting component 394. Opposing edges of the outer sleeve and innerstem may further exhibit such as serrated/ratchet teeth as shown and inorder to maintain a selected height established between the components,such as following insertion and manipulation of a pair of pliers (notshown).

FIG. 39 is a further illustration at 396 of an inboard screw liftvariant, this exhibiting lift components similar to those shown in FIG.38, and in which an opposing outer sleeve 398 and inner stem 400 eachfurther exhibit opposing and screw adjustable threads placed thereon.This allows for (rotating) adjusting screw lift to achieve a desiredheight between the vertebrae supporting components. In this variant, theouter sleeve 398 is freely rotatable relative to the upper spinalprocess 399 to which it is mounted, with the inner stem 400 optionallybeing fixed in mounting position to lower associated process 401.

FIG. 40 is an illustration at 402 of a “U” shaped spacer component 403in cross section and which is secured at an inner converging location ofa pair of lumbar vertebrae. The component 402 provides a simplified andeffective example of a dynamic and biasing insert which is utilized atan inner converging/supporting location between the vertebrae and which,upon being rotated, causes a modification of the outer sleeve 398′asshown in FIG. 39 to include threads on its outer annular face and which,in combination with inner stem 400′, transfers rotation of the spacercomponent 403 to elevation of the assembly.

FIG. 41 is an illustration 404 of an inboard screw ring lift, thisfeaturing the general configuration of the sleeve and stem shapedcomponents of FIG. 39, and by which an outer (and individuallyactuating) rotatable ring component 406 is employed for establishing aselected lifting displacement between stationary upper 408 and lower 410vertebrae supporting components.

FIG. 42 is an illustration generally presented at 412 of a furthermodified lift jack incorporated at an interface location betweensucceeding spinal vertebrae 414 and 416 (see also spinal nerve column 48as originally shown in FIG. 1). The construction of the jack assembly,further referenced at 418 is provided consistent with any of thedescriptions previously given and, as a further measure, illustrates thefeature of arcuate extending anchoring screws, at 420 and 422, eachfurther exhibiting errated end fixing portions 424 and 426.

As further shown in FIG. 43, an outer guide sleeve 428 is incorporatedinto such as an interior seating passageway associated with a lower halfof the jack (further at 430 in FIG. 42). The selected screw 420 shownalso includes an enlarged spherical head 432, such as which seats withinan access aperture 434 defined in the lower body.

The anchoring screws 420 and 422 in this variant exhibit a degree ofarcuate bend or flex and, in use, are designed to insert and engage in amore desirously locating and retaining fashion within associated bonelocations (see again in FIG. 42) associated with the selected vertebrae416, and than is typically permitted by linear (straightened) screws.The sleeve 428 is an optional feature, it also being understood that thescrews can mount directly into integrally defined passageways within thelower body half of the jack.

Prior to installation of the anchor screws 420 and 422, undercutpatterns (see again in FIG. 42) are machined into mounting surfaces ofthe vertebrae, such as using a sophisticated medical drill with suitablebit configuration for creating the desired undercut profile. Duringinstallation, such as by pushing inwardly on the spherical exposed end432, the flexible/dovetail end configurations 424 and 426 (theseexhibiting any desired modulus of hardness or flexibility) are pushedinto the defined passageways in the vertebrae and are successivelypinched and then re-expanded to seat in the bone in a withdrawalresistant manner.

FIG. 44 is a successive view of a screw 438 and associated sleeve 440 ina further more straightened configuration, relative to that shown inFIG. 43. It is envisioned that the geometry of screw can be provideaccording to any desired degree of arcuate angle or bend and in order tobe displaceable through the jack body in a desired direction in order tomount to the vertebral bone.

Referring now to FIG. 45, an illustration is generally shown at 442 of afurther elevating jack, such as according to any of the differentvariants previously disclosed, and which exhibits opposite and outertextured surfaces, at 444 and 446 associated with upper 448 and lower450 portions. The design of the textured surfaces, this including anymanner of roughening or serrating of the outer body locations associatedwith the upper and lower concave and ergonomically defined recesses,assists in locating and gripping opposing vertebral locations. As willbe subsequently described in reference to succeeding embodiments, thedesign of the surface texturing is intended to promote both the initialfrictional location of the exterior jack surfaces against desiredmounting surfaces of vertebrae (such as concurrent to the installationof mounting anchors or fasteners), as well as promoting the naturalphenomena of encouraging the generation of natural bone marrow growth atthe contact locations, this promoting long term engagement of the jackwith or without the use of separate fasteners.

FIG. 46 is a yet further example, generally at 452, of a fixed andincreased height jack exhibiting similar textured surfaces 454 and 456defined on dovetail shaped opposing profiles, the textured surfacessimilar to what is also shown in the variant of FIG. 45. The presentinventions also contemplate, in addition to providing a single andelevate-able/adjustable jack, the provision of a plurality ofindividually sized and fixed jacks, such as shown in FIG. 46, in a kitform and which can individually sized for installation in situ withinthe patient.

FIG. 47 is an illustration at 458 of a pad surfacing associated, thisshown in planar profile and which is understood to exhibit asufficiently thin and flexible construction such that it is capable ofbeing installed upon an ergonomic engaging surface corresponding withupper and lower contact locations of the spinal jack (see FIG. 48). Thepad 458 is again constructed of a sanitary plastic or admixed compositematerial and exhibits a desired and grid-like and interconnectingundercut pattern (see undercut diamond portions at 460, 462, et seq.)for promoting generation and adherence of naturally occurring bonemarrow.

FIG. 48 is a plan view of an elevating jack 464 incorporating the marrowgrowth promoting patterns on each of surface configured upper 458′ andlower 458″ facing patterns associated with upper 466 and lower 468 jackhalves;

FIGS. 49-57 illustrate a succession of plan cutaway views of furthermodified undercut patterns for promoting the adhesion of marrow betweenspinal jack surfaces and their respective upper and lower vertebralcontact locations, with the understanding that such patterns can besubstituted in the cutaway of the jack design in FIG. 48 and alternativeto the undercut pattern 458 shown in FIG. 47. Specifically, FIG. 49illustrates at 470 a pattern incorporating a plurality of generallysemi-spherical shaped apertures. FIG. 50 illustrates a 472 a double looparrangement 472. FIG. 51 shows at 474 ball/slot type configuration. FIG.51A further shows a modified (and double layer) dovetail pattern, at476, this in comparison to that previously shown in FIG. 47.

Referring to FIG. 52, a double hook pattern is referenced at 478,whereas FIG. 53 illustrates a more general dovetail configuration 480approximating that of FIG. 47. FIG. 54 illustrates, a 482, a raisedeyelet configuration, with FIG. 55 further illustrating, at 484, areverse/inwardly dovetail slice pattern. FIG. 56 shows, at 486, a raisedball pattern (of varying heights and mounted to base supported stems),with FIG. 57 successively showing a raised tee configuration 488.

The undercut patterns disclosed herein are selected from representativedesigns, it being understood that an unlimited variant of patterns anddesigns are capable of being employed to promote marrow growth andadhesion. Although not shown, it is further envisioned that additionalopposing and bonding patterns are capable of being either textured into(such as by a drill) or installed upon (in the case of additional matportions) the mounting locations of the vertebrae and which, incombination with the designs illustrated herein, assisting in fixedlysecuring either or both the upper and lower assembled jack portions atthe desired vertebral bone locations.

Referring now to FIG. 58, an illustration is generally shown at 490 of ayet further variant of spinal jack having a one piece plasticizedconstruction and illustrating upper 492 and lower 494 generallyclamshell halves interconnected along a living hinge 496 from whichextend both upper 498 and lower 500 facing and boundary definingsurfaces. A key aperture defined passageway 502 is defined in an endlocation communicating with the boundary interface established betweenthe clamshell halves 492 and 494, opposite the flexible or living hinge496.

As further shown in FIG. 59 and in cutaway fashion in FIG. 60, and uponinsertion of a key 504 within the aperture 502, the flexible halves 492and 494 are caused to outwardly deflect in the manner shown about theliving hinge 496. As further shown in FIG. 58, the key 504 exhibitsprofiled upper 506 and lower 508 surfaces which mate and coact withthose defining upper 510 and lower 512 perimeter surfaces of the keyaperture/passageway 502. An aperture 514 is defined in a planar end face516 of the key 504 and which is engaged by a tool bit inserting portion(not shown) in order to inwardly displace and engage the key 504 withinthe interior pocket shape of the expanded jack (again FIG. 60).

Also shown at 518 in FIG. 60 is an inward facing step surface associatedwith the lower boundary defining surface 500, proximate an outer liplocation and which provides an end-stop abutment to prevent inadvertentdislodgement of the key. Exteriorly facing concave or dovetail likeengaging surfaces are also shown at 520 and 522 respectively associatedwith the upper 492 and lower 494 clamshell halves.

FIG. 61 is a perspective illustration of a spinal jack 524 according toa yet further preferred embodiment. As further shown in the pre and postexpansion cutaway views of FIGS. 62 and 63, the spinal jack includes anupper body 526 and a lower body 528, each further including a desiredconcave or pseudo dovetail exposed surface 530 and 532 (FIG. 61) tofacilitate location relative to the vertebrae.

As shown, the upper body 526 includes a pair of projecting grooves ortracks, at 534 and 536, and which extend downwardly to seat withincorresponding slots 538 and 540 associated in opposing locations of thelower body 528. FIG. 62 further illustrates a ball 542 seating within afirst larger configured pocket (see inner facing and boundary definingsurfaces 544 and 546) established between opposing interior surfaces ofthe body halves and which are located proximate an access aperture 548(see FIG. 61) defined in the upper body 526.

As further shown in FIG. 63, which is a succeeding illustration to thatshown in FIG. 62, the ball 542 is illustrated being laterally displacedalong the interior boundary established between the opposing halves to afurther smaller configured and rearward displaced pocket (see furthercommunicating and configured inner surfaces 550 and 552) correspondingto a linearly expanded position. A folded over and living hinge 553 isassociated with the selected track 536 and, upon being linearlydisplaced in an outward direction relative to the slot configuration540, provides additional linear retaining support between the bodyhalves. It is also envisioned that the respective dimensions of therespective rails and slots can also be modified to account for thesurface patterns defining the pockets.

FIG. 64 is an illustration at 554 of a cam lift configuration of spinaljack according to a yet further embodiment in a first collapsedposition. FIG. 65 is a succeeding illustration to that shown in FIG. 64and showing upper 556 and lower 558 portions in a successive expandedposition, such as incorporating a groove and slot arrangement and inertdisplaceable ball as shown in FIG. 62. It is also again understood that,alternative to making the jack expandable, the present inventions alsoenvision providing a plurality of individually sized and fixed dimensionjacks in kit form for pre-sized installation.

Referring now to FIG. 66, an illustration 560 is shown of a rotationallift variant of spinal jack incorporating outer disk portions 562 and564, between which is sandwiched a rotatable inner portion 566. A seriesof perimeter extending and coacting surfaces are established between theouter disks 562 and 564 and the inner rotating portion 566, in order tocause outward displacement of the disks in a direction generallyreferenced by outer direction arrows 568 and 570.

Although not clearly shown, coacting surfaces are further visible at 572(inner facing side of disk 562) and at 574 (opposing surface of innerrotating portion 566), these further exhibiting any desiredprojecting/recessed pattern to encourage outer lateral displacement upona surface exposed slot, as selectively shown at 574 in FIG. 66, beingengaged by a tool 576 (FIG. 67) which includes inner opposing and bitengaging portions and in order to rotated the inner portion 566 torelatively expand the outer disks 562 and 564. The opposite facing slotsare defined in a collar support, at 578 in FIG. 66, which permits theouter disks to expand in controlled fashion relative to the coaxial andsandwiched inner rotating component 566.

FIG. 68 is an illustration of a clamshell constructed spinal jack 580,similar in many respects with that previously shown in FIG. 58 and againincluding a one piece plasticized construction and illustrating upper582 and lower 584 generally clamshell halves interconnected along aliving hinge 586 from which extend both upper 588 and lower 590 facingand boundary defining surfaces. A modification of a key aperture definedpassageway 592 (FIG. 68) is defined in an end location communicatingwith the boundary interface established between the clamshell halves 582and 584, opposite the flexible or living hinge 586.

FIG. 69 is a lineal cutaway of the clamshell design as shown in thepre-expanded position of FIG. 68 and incorporating a pair of innerdisposed and communicating seating pockets, see as defined by opposingwalls 594 & 596 and 598 & 600 and which is again similar as shown in thevariant of FIG. 62 with a ball 602 pre-seated within the first enlargedpocket defined by opposing walls 594 & 596. As further referenced inFIG. 70, and upon inserting a tool into the passageway 592 incommunication with the ball 602, the clamshell halves 582 and 584 areoutwardly deflected in response to the ball 602 being displaced linearlyto and reseated within the second smaller configured pocket (againdefined by walls 598 and 600).

Referring now to FIG. 71, an illustration is shown at 604 of a cam liftvariant of a displaceable spinal jack and including an upper body 606and a relatively displaceable bottom 608. Similar in respects to thedescription previously given as to the embodiment of FIGS. 61-63, theupper body half 606 includes a pair of lengthened and projecting rails610 and 612, these seating within like opposing and deepened slots 614and 616 (see in particular cutaway views of FIGS. 72 and 73).

An inner rotatable cam element 618 is rotatably supported in crosswiseextending fashion, such as relative to the upper body half 606. The cam618 includes an eccentric contacting surface 620 which, upon engaging atool bit into a receiving aperture 622 associated with the element 618,is rotated from a first position seating within an inner pocket (seesurface 624) defined in the upper body 606 in a generally clockwisedirection and to facilitate outward displacement (upon contactingprofiled opposing surface 626 of the lower half 608) of the halves asfurther shown in FIG. 73.

FIG. 74 is an illustration at 628 of a still further variant of spinaljack insert and which illustrates a displaceable wedge lift 630 (seeFIGS. 75 and 76) supported within a track 632 associated with the lowerjack half 634. The wedge lift 630 exhibits an upper stepped profile 636which is engageable with a mating and downwardly stepped profile 638associated with an upper assembled jack half 640. A key aperture isshown at 642 and, in the first retracted and design position of FIGS. 74and 75, seats a side inserting portion 644 of the displaceable wedgelift 630. FIG. 76 is a successive illustration of the jack in which thewedge 630 is displaced, via such as a tool inserted into the interiorkey access hole 642 and in deflecting fashion against the side portion644, and in response upwardly steps the upper half relative to the lowerhalf concurrent with the travel of the wedge 630 progressively steppingalong the downward direction of the upper half stepped profile 638.

FIG. 77 is an illustration of a rear insert wedge variant 646 of aspinal jack according to a yet further variant and including a similararrangement to that previously disclosed with upper half 648 and lowerhalf 650, the upper half including a single downward rail 652 whichseats within an opposing receiving slot 654 defined within the lowerhalf. A tapered key 656 is provided and inserts through an initiallynarrowed width extending aperture (at 658 in FIG. 77) defined at aninterface boundary between the upper and lower halves.

The configuration of the key 656 is such that it linearly expands theupper and lower halves 648 and 650, via contact between the sloped key656 and associated sloped surface 658 of the lower half 650, and fromthe initial position shown in FIG. 78 to the expanded position of FIG.79, this while at the same time providing shouldering support at theinlet side (via contact with upper half sloped inner surface 660) andconcurrent with the displacing support established between the rail 652and associated slot 654. Although not shown, it is understood that anadditional rail/slot can be designed to overlap the inlet side where thekey 656 is installed and, further, a flexible and end-connected hingeportion could also be installed similar to previously depicted at 553 inFIG. 63.

Referring to FIG. 80, a further variation of a rear insert wedge lift isshown at 662 incorporated into a further modified variant of clamshelldesigned spinal jack 664, again including upper 666 and lower 668interconnected halves with rear living hinge 670. The wedge lift 662includes concave and arcuate extending surfaces 672 and 674 (FIG. 80)extending from upper and lower edges of a planar surface (againidentified at 662) within which is defined a bit engaging aperture 676.As further shown in FIG. 81, and upon linearly displacing the wedge 662so that its contoured surfaces 672 and 674 align with and coact againstopposing upper arcuate profile 678 and lower planar profile 680, thejack halves are likewise outwardly actuated and expanded in the mannerillustrated.

FIG. 82 is a cutaway illustration of a further variant of jack lift 682,along the general principles of the previous variant in FIG. 26 andshowing an inner displaceable wedge component 684 seated within a planarinner base surface 686 of a lower jack half 688, and which is arrangedin stepped/serrated engagement (see stepped upper surface 690) relativeto an inwardly facing stepped and angled boundary 692 of an assembledupper jack half 694. The design of the upper hack half 694 (consistentwith a number of the variants previously described and illustrated) isfurther such that it includes an outer overlapping lip 695 which extendsaround a supporting wall 696 associated with the lower half 688. Thewedge component 684 is displaced either linearly or rotatably, in thelatter instance in cooperation with an arcuate winding profileincorporated between the stepped surfaces 690 and 692 in a threedimensional arc and so that the upper half 694 is caused to elevaterelative to the lower half 688.

FIG. 83 is a modification 698 of the jack lift of FIG. 82 whichillustrates a bit receiving portion 700 associated with and extendingfrom the wedge component 702 mounted in similar fashion within upper 704and lower 706 jack halves. Not shown is a tool for engaging the bitportion 700 and rotating the wedge component 702 in a rotationaldirection (see rotated position 700′ and 702′ in phantom) outside of theupper and lower assembleable halves for assisting in stepped outerdisplacement of the jack halves;

FIG. 84 is a crosswise cutaway illustration 708 of a further example ofspinal jack according to any one of a number of alternate configurationswith assembleable upper and lower jack halves (not shown). Further shownis a tool 710 with inwardly opposing and offset bit portions 712 and714, these align with and are received by a pair of like offset andinwardly displaceable wedge portions 716 and 718 associated with thespinal jack. FIG. 85 is a succeeding illustration to FIG. 84 and showingthe tool bits 712 and 714 inwardly displacing the wedge portions 716 and718, against an outward spring bias associated with each, and into acentral aligned configuration, this consisting with suitable surfaceconfigurations established between the corresponding upper and lowerjack halves for causing outward expanding displacement.

FIG. 86 is a successive crosswise illustration of a modified jack insert720 and showing a pair of spaced apart tool bit insert portions 722 and724, which are positioned in an initial and pre-expanding conditionrelative to a pair of alternating stepped configurations, further at 726and 728, established between upper and lower jack halves (not shown).FIG. 87 is a succeeding displaced illustration to that shown in FIG. 86and by which the concerted outer lineal displacement of the bit insertportions 722 and 724 (see arrows 730 and 732) corresponds to lateraledge directed displacement of coacting ramped portions (see further at734 and 736 displaced in opposite lateral directions 738 and 740)associated with the boundary established between the upper and lowerspinal jack halves, this again resulting in outward relativedisplacement of the jack halves.

Each of the variants of FIGS. 84 and 86, although illustrated in agenerally central 2D cutaway, are intended to depict possible expansionvariants in which a pair of concurrent displacing components areprovided for actuation by an appropriate tool and in order to outwardlyexpand upper and lower halves of the jack assembly. That said, it isunderstood and envisioned that the inner facing and coacting surfaces ofthe upper and lower halves can exhibit any desired profile or shapewhich interface with the configuration and contour of the displaceablecomponents.

Referring now to FIG. 88, an environmental illustration is shown at 742of an assembleable jack brace according to a further embodiment forinstallation over extending processes 744 and 746 (such as superiorarticular processes associated with the vertebrae). As will be describedin further detail, the brace includes a generally ladder-likeconfiguration with a first assembleable stem 748 and an opposingattachable stem 750. The stem 748 includes a plurality of spaced apartand outer retaining sleeve portions 752, within which are seated inengaging fashion aligning inner portion 754 associated with the opposingstem 750. The sleeve portions 752 and aligning inner portions 754 extendsuch as crosswise from the generally linear extending stems 748 and 750and, upon assembly bias upper and lower surfaces of the individualprocesses 744 and 746. This is illustrated in FIG. 88 by upper processes744 positionally limited or restrained within an upper window definedbetween an upper pair of sleeves/inserting portions, with a lower pairof sleeves/inserting portions likewise defined a further lower windowfor restraining the lower succeeding processes 746.

The pattern and arrangement of the spaced apart engaging stems is suchthat they define individual window locations corresponding to seatingand supporting displacement of articular processes 744 and 746. In thisfashion, the assembly of the braces, such as which are again constructedof a durable plastic or lightweight metal, provides any degree of fixedor limited motion between the vertebrae and given the relative dimensionof the window portions such as illustrated and through which therespective vertebral processes 744 and 746 extend.

FIG. 89 is a further and related environmental illustration 756 of ajack brace such as shown in FIG. 88 and which is redesigned withlengthened support stems 758 and 760 for supporting a plurality of threesucceeding vertebral processes 744, 746 and 747. As with the smallersized variant of FIG. 88, the first stem 758 includes a first pluralityof spaced apart and outer retaining sleeve portions 762, within whichare seated in engaging fashion aligning inner portion 764 associatedwith the opposing stem 760.

As with the variant of FIG. 88, the outer sleeves and inner insertingstems can include any desired snap-fit construction to retain them inposition. This is further represented in reference to FIG. 90, which isis a lineal cutaway illustration of an assembleable spinal processesbrace such as illustrated in FIG. 88 and further depicting the manner inwhich the outer sleeves 752 can exhibit inner projections 766 whichengage recess grooves 768 defined in annular fashion about a midpoint ofthe inner inserting portions 754, thereby defining a specified snap fitengagement between the stem portions.

FIG. 91 is a cutaway illustration of a further succeeding variant 770 ofspinal process supporting brace with modified stems 772 and 774 andfurther showing first 776 and second 778 side engageable plug fastenersarranged in intermediate inserted and pre seating/locking positionsrelative to an inwardly notched interface associated with the stem 772and in opposing engagement to a pair of outer seating sleeves 780 and782. The outer seating sleeves 780 and 782 are further associated withthe side stem assembleable half 774 and which receive the insertingportions 776 and 778, also termed inner male portions. As shown, theinserting portions 776 and 778 define inner resilient plugs and arelinearly displaced to the fully installed position of FIG. 92, and bywhich they seat within additional pre-located portions 784 and 786arranged within the sleeves 780 and 782 and, upon full installation ofthe inserting portions 776 and 778, are outwardly expanded so thatannular projections 788 seat within aligning annular recesses 790defined between the inserting portions 776 and 778 and the outer sleeves780 and 782.

Referring to FIG. 93, illustrated at 792 in partially exploded fashionis a further variant of assembleable spinal process jack brace, similarin respects to that shown in FIG. 89 and which is assembleable in orderto restrain a plurality of three successive vertebral superior articularprocesses. The brace 792 in this variant includes upper and lowerassembleable pairs of stems, see upper opposing pair 794 & 796 withlower opposing pair 798 and 800. As with previous embodiments, alsoprovided are pluralities of opposing outer sleeves, see at 802 and 804with reference to upper 794 and lower 798 stems, and inner insertingportions, see further at 806 and 808 (largely hidden from view in FIG.93) for each of upper 796 and lower 800 stems.

Also provided are end disposed and opposing/aligning dovetail seatingportions established between intermediate mating locations of the upper794/796 and lower 798/800 pairs of stems. As shown in FIG. 93, the lowerstems 798/800 each include an upwardly projecting and dovetail shapedportion 810 and 812, these seating within inner opposing and matingdovetail recesses (see as shown at 814 in FIG. 93) and so that, asreferenced in the fully assembled view of FIG. 94, the brace can beprogressively assembled as upper and lower halves in order to moreeasily and less intrusively assembly about the spinal processes andwithout damage to or interference with the associated spinal column.

FIG. 95 illustrates at 816 a two process spinal brace such as shown inFIG. 88 with first 818 and second 820 side assembleable halves withopposing and assembled sleeve and inserting portions. Referring furtherto FIG. 96, an illustration is presented at 822 of a further variant ofan initially assembleable and subsequently extensible spinal processbrace and which is shown in a first retracted position exhibitinglinearly expandable upper and lower halves. Similar to that previouslydescribed in the variant of FIG. 93, the upper half includes a pair ofassembleable upper stems 824 & 826 and a further pair of assembleablelower stems 828 & 830. As will be further described in reference to thelineal cutaways of FIGS. 98 and 99, a pair of intermediate and innersupporting portions 832 and 834 are provided and coact with elevateddisplacement of the outer stems (see FIG. 97) in order to established anelevated condition associated with the pairs of engagingsleeve/inserting portions generally identified with upper assembled stemat 836 and with lower assembled stem at 838.

Referring further to FIG. 98, a lineal cutaway illustration of the braceshown in FIG. 96 and showing the manner in which the inner supportingportions 832 and 834 support the upper and lower pairs of stems in afirst hidden position corresponding to the stems being retracted asshown in FIG. 96. Arranged on both sides of the brace are pairs 840 and842 of inner seated and outer biased coil springs, these arranged withinthe supporting portions 832 and 834 as shown. The pairs of coil springs840 and 842 include surface defining portions 844 and 846 (see also FIG.96), respectively and, as further shown in FIG. 98, are surface exposedin aligning fashion through gaps existing between lower boundaryabutting locations of the upper stems 824/826 and lower stems 828 and830.

FIG. 99 is a successive lineal cutaway of the brace shown in FIG. 96 andin which the opposite located pairs of opposite/lateral positioned andoutwardly spring biased portions 840/842 with associated inwardlydeflectable surface portions 844/846 are simultaneously inwardlydisplaced (see arrows 843 and 845). At this point, the upper 824/826 andlower 828/830 pairs of stems are permitted to linearly expand in themanner shown. Upon the apertures revealed by the previously inwardlydeflected spring portions 840 and 842 being outwardly relocated andsubsequently aligned with additional lineal extending and opposite pairsof spring loaded portions 848 and 850 with surface exposed portions 852and 854 (these shown in collapsed position in FIG. 98), the surfaceportions 852 and 854 are permitted to outwardly deflected (see arrows853 and 855) in the manner illustrated (see also FIG. 97) in order tofixedly reposition the upper/lower assembled brace halves in theexpanded condition relative to the intermediate supported portions 832and 834.

Pairs of lineal end springs, see at 856 and 858 are defined betweenextending inner guides (at 860 and 862) at projecting upper and lowerends of the inner supporting portions 832 and 834 and which bias againstinner defined pockets 864 and 866 formed axially within an interior ofeach of the stem portions 824, 826, 828 and 830. In this fashion, inwarddisplacement of the initially exposed surface portions 840/842 resultsin the lineal springs 856/858, such as coil springs, outwardlydisplacing the upper and lower assembled stems to the location at whichthe initially embedded and subsequently expanded surface portions852/854 are permitted to outwardly reseat within the window openingscaused by the opposite expanding stems relative to the support providedfrom inner portions 832 and 834.

FIG. 100 is a perspective view 868 of a further modified and generally“H” shaped spinal brace assembly in a first retracted position and whichincludes a central assembleable and process defined support, thisfurther including a first piece 870 including a stem and integrallyformed and spaced apart pair of outer sleeve 872 and 874, as well as asecond piece 876 with a second stem and a pair of integrally formedinserting portions 878 and 880. Upper 882 and lower 884 pairs oflinearly outwardly displaceable vertebral engaging portions are definedand which seat within interior recess locations defined in each of thestem defined pieces 870 and 876.

As shown in FIG. 100, the upper 882 and lower 884 displaceable portionsare substantially recessed within the stem defined interior passageways.A pair of central/side positioned and inwardly displaceable buttonportions 886 and 888 are provided and are linkage connected to the upper882 and lower 884 individual pairs of outwardly displaceable portions soas to cause the portions 882 and 884 to oppositely displace (see FIG.101) such as in order to abut opposing support surfaces includinglateral processes locations (see 18, 18′, 20 and 20′ in FIG. 1) whilethe window created by the brace 868 is seated around such as superiorarticular processes 27 or 29.

As further represented in the prior environment view of FIG. 88, theopposing outwardly displaceable portions 882 and 884 can, uponpre-installing the brace assembly of FIG. 100, between a desired spinalprocess such as shown at 744, engage additional transverse processlocations as further shown in FIGS. 88 at 890 and 892. Additionally, andalthough not further described in detail, it is envisioned andunderstood that any suitable linkage can be employed for translating aninner directed displacing force on the buttons 886 and 888 to result inan outward deflection of the displaceable portions 882 and 884 in themanner desired.

Having described my invention, other and additional preferredembodiments will become apparent to those skilled in the art to which itpertains and without deviating from the scope of the appended claims:

I claim:
 1. An expandable spinal insert adapted for insertion betweensucceeding spinal vertebrae, comprising: a body including upper andlower assembleable halves, wherein each of said assembleable halvesexhibits a concave exterior adapted to seat against an opposing locationof an articular process associated with a selected vertebrae, andwherein said upper half further exhibits a tapered and perimeterdefining lower edge configured to overlap a perimeter defining upperedge of said lower half; and a plurality of arcuate shaped screws,wherein each arcuate shaped screw includes an enlarged head at a firstexposed end and a vertebrae fixing portion defined at an opposite end,and wherein said vertebrae fixing portion comprises a flexible, dovetailconfiguration defined by a plurality of serrations, and wherein saidflexible, dovetail configuration is configured to be received in awithdrawal resistant manner in a mating undercut profile formed in avertebral mounting location; and wherein said lower assembleable halfincludes a plurality of accessible apertures for receiving therethroughsaid enlarged heads of said arcuate shaped screws such that each arcuateshaped screw is seated within an accessible aperture, and wherein saidvertebrae fixing portion of each arcuate shaped screw projects throughsaid lower assembleable half and out a lower surface location of saidlower assembleable half for mounting to a vertebra; and wherein saidassembleable halves further define an interior including a bevelingarrangement, wherein said beveling arrangement includes a rotatablefirst screw drive component formed within said lower assembleable halfand extending across said interior defined within said assembleablehalves, and a second screw drive component extending in a crosswiserelationship relative to said first screw drive component, said secondscrew drive component exhibiting an exterior screw pattern which isactuated in a bevel-like fashion upon rotation of said first screw drivecomponent in order to outwardly displace said upper assembleable halfrelative to said lower assembleable half.
 2. The spinal insert asdescribed in claim 1, further comprising a keyway location defined insaid lower assembleable half in communication with said first screwdrive component and which is adapted to receive an inserting bit end ofa rotating tool.
 3. The spinal insert as described in claim 1, whereineach arcuate shaped screw is configured to extend through an outer guidesleeve supported within each vertebral mounting location.